sc brand toolkit ppt 1 · 2020-05-11 · presentation) cocaine exposure heightened arousal...
TRANSCRIPT
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Booster
Methylphenidate Amphetamine
Concerta: 18mg36mg54mg
Adderall XR:10mg20mg30mg
Focalin XR: 10mg15mg20mg
Vyvanse:30mg50mg70mg
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Greenhill et al. JAACAP 2006.
Greenhill et al. JAACAP 2006.
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MPH IR
2.5 mg PO BID
x7d
MPH IR
5 mg PO BID
x7d
If effective AND well-tolerated, consider switch to
once daily formulation,
NTE 10mg/day
ADHD ASD
Socia
l
Inattention
Hyperactivity
Communication
RRBI
• Double-blind, placebo controlled, crossover trial with open label
continuation using MPH in children with moderate to severe
hyperactivity
• N=72, ages 5 to 14.
• 49% responded with ES = 0.2-0.54
• SEs led to 18% attrition.
MPH IR
2.5 mg PO BID
x7d
MPH IR
5 mg PO BID
x7d
Consider switch to
long acting,
proceed with
caution
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Concerta18mg x7d
Concerta36mg x7d
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Optimal
Disorder Dysfunction Differences Stimulus changes needed
Autism Easily over aroused Downward shift in need for central
stimulation or reduced ability to modulate or habituate stimulus
input
Reduce sensory input
ADHD Under aroused Shift in level of central stimulation
found to be optimal from inadequate neurotransmission of
incoming stimulation
Respond to stimulant
medications and increases in arousal
FAS Arousal dysfunction Slower gating of incoming
stimulation and reduced capacity to inhibit attending to distracting
stimuli
Respond to simplification of
sensory input (fewer distracters and slower
presentation)
Cocaine
Exposure
Heightened arousal
responses
Over aroused by stimulation and
difficulties returning to baseline levels. Also has difficulties with
maintaining inhibitory control
Monitoring of arousal level
so stimulus input can be modified when too high.
Longer periods allowed for recovery of functioning
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